(July 2004, Finland) I accepted a post as General Practitioner for a small
village in the Finnish forests. In Scandinavia, Finland is the butt of
jokes concerning mosquitoes, trees, and excessive alcohol consumption, so I
can't say I hadn't been warned. But nothing could have prepared me for
the stories behind the wounds I treated! In defense of the patients, their
government had just halved the taxes on alcohol...

CASE 1: A young male I'll call Pekka came in on a Wednesday, as the damages
from a weekend of heavy partying began to bother him. Lacerations and
abrasions covered his entire backside, from his ankles to the top of his
head. But Pekka's main concern was a dislocated thumb. It was sticking
out at a 90-degree angle from his palm, and coloured a nice shade of
purple. I ordered X-rays. Luckily for Pekka, he had no fractures, and we
reset his thumb joint.

How had these wounds occured?

Pekka's friend was driving him home from the local waterhole. As they sped
along somewhat faster than the speed limit, as one does when one is living
in the middle of nowhere, Pekka realized that the driver was as drunk as he
was! He decided to take action, and get out of the car. While the driver
was preoccupied with a sharp bend in the road, Pekka opened the passenger
door and quit the car.

Pekka was a regular customer over the summer, coming in when the
anaesthetic effects of a weekend's libations began to wear off. He had his
cast replaced, and the thumb reset, and reset, and reset yet again. I am
sure he's still out there working towards a Darwin Award!

CASE 2: A middle-aged woman came in complaining of a horrible headache.
Two days earlier, she had been driving to work when she suffered a
"blackout" and woke up upside down. Her car was now resting on its roof.
She extricated herself and walked to work! But the headache had grown
steadily worse. She thought it might be whiplash.

To demonstrate that the pain was worse when she moved her head, she
suddenly started shaking her head vigorously! The nurse and I both jumped
to intervene, and hold her until we could fit a collar and have the
madwoman transported by gurney to Radiology. She had a fractered cervical
vertebra, which luckily had not been displaced even though she'd done her
very best right there in my office! She, too, lived to tell the tale.